Design of the study:
Retrospective, observational, single center

Methods:
-Chart review of critically ill, cardiac children up to 18 yo who received prolonged infusions of DEX ≥96 hrs)

-Between Jan 2009-Mar 2010

-Compared with control group (sedation without DEX)



Results:
-N: DEX: 52, Control: 42

-Risk adjusted classification for congenital heart surgery-1 score, ventricular ejection fraction and proportion for mechanical ventilation were the same 

-Duration of continuous midazolam and morphine was significantly lower in Dex group

-Number of sedatives for "rescue" 

-Hemodynamic effects were not different in the two groups

-MAP was higher in first and sixth hours after termination of DEX

-No difference in respiratory rate, blood pH, PaO2, PaCO2 and base excess, days of mechanical ventilation, LOS in hospital/ICU, or hospital mortality between the two groups

-Upon terminations: 12% in DEX vs 2% in control had rebound hypertension, 8% vs 0% rebound tachycardia

-Clonidine requirement was higher in DEX (31% vs 7%)



Conclusion:​

-Prolonged dex infusions, defined as ≥ 96 hrs is safe, leads to decreased opioid, benzodiazepine and inotropic requirement

​

Interesting points:​

-Inotrope support was significantly less in Dex group up to 6 hours after termination

-No difference in duration of mechanical ventilation, length of stay in ICU or hospital

-One patient experienced junctional rhythm at 130 beats/min